Healthcare Provider Details

I. General information

NPI: 1437676251
Provider Name (Legal Business Name): NANCY REID BYRNE CNM, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2017
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8639 MAYLAND DR STE 102
RICHMOND VA
23294-4752
US

IV. Provider business mailing address

4200A TECHNOLOGY CT
CHANTILLY VA
20151-1214
US

V. Phone/Fax

Practice location:
  • Phone: 804-993-3039
  • Fax:
Mailing address:
  • Phone: 540-709-1737
  • Fax: 866-611-6315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number0024175241
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number0024175241
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024175241
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: